Malignant neoplasms of the oral cavity and oropharynx treated in Brazil: what do hospital cancer records reveal? / Neoplasias malignas da cavidade oral e orofaringe tratadas no Brasil: o que revelam os registros hospitalares de câncer?

Abstract Introduction: Head and neck cancer has an impact on the global burden of diseases, representing an important cause of morbidity and mortality in Brazil, as well as worldwide. Objective: To learn and describe the clinical, epidemiological and care configuration provided to patients with cancer of the oral cavity and oropharynx recorded in Brazil, diagnosed from 2007 to 2016. Methods: This is a cross-sectional study, carried out using secondary hospital-based data, using the indirect documentation technique. Results: There were 52,799 hospital records of oral cavity cancer and 34,516 cases of oropharyngeal cancer in the assessed period. There was a predominance of male patients, aged 50-59 years, mostly Caucasians, and with a low level of schooling. Throughout the period there was a significant reduction in the positive history of alcohol and tobacco consumption, except for alcoholic beverages in oral cavity cancer. Most patients were diagnosed at an advanced stage of the disease (III or IV). Most patients with oral cavity cancer had no evidence of the disease on follow-up, while most patients with oropharyngeal cancer died. The first most frequent treatment offered to patients with oral cavity cancer was surgery, while for patients with oropharyngeal cancer it chemoradiotherapy predominated. Conclusion: Despite the fact that, in general, there was a reduction in the records of patient alcohol and tobacco consumption, the increase in the number of medical consultations, the predominantly late diagnosis and the patients' low level of schooling indicate the need for health education, primary prevention and early diagnosis of cancer of the oral cavity and oropharynx.

Resumo Introdução: O câncer de cabeça e pescoço impacta a carga global de doenças, representa importante causa de morbimortalidade no Brasil e no mundo. Objetivo: Conhecer e descrever a compleição clínica, epidemiológica e assistencial dos atendimentos a pacientes com câncer de cavidade oral e orofaringe registrados no Brasil, diagnosticados de 2007 a 2016. Método: Estudo transversal, feito a partir de dados secundários de base hospitalar, por meio de técnica de documentação indireta. Resultados: Houve 52.799 registros hospitalares de câncer de cavidade oral e 34.516 casos de câncer de orofaringe no período considerado. Predominaram pacientes do sexo masculino, da faixa etária de 50-59 anos, predominantemente branca, e de baixo nível de escolaridade. Ao longo do período houve redução expressiva do histórico positivo de consumo de bebida alcoólica e tabaco, exceto para bebida alcoólica no câncer de cavidade oral. A maioria dos pacientes foi diagnosticada em estágio avançado da doença (III ou IV). A maior parte dos pacientes de câncer de cavidade oral apresentava-se sem evidência da doença, enquanto que grande parte dos pacientes com câncer de orofaringe evoluiu a óbito. O primeiro tratamento mais frequente oferecido aos pacientes com câncer de cavidade oral foi cirurgia, enquanto para os pacientes com câncer de orofaringe foi a quimioradioterapia. Conclusão: Apesar de se observar, de maneira geral, redução dos registros do consumo de bebida e tabaco, o aumento do número de atendimentos, o diagnóstico tardio predominante e o baixo nível de escolaridade dos pacientes apontam para a necessidade da educação em saúde, de prevenção primária e do diagnóstico precoce do câncer de cavidade oral e orofaringe.

Displasia fibrosa monostótica simulando proceso neoformativo intraoral en una paciente con sida. Primer caso reportado en esta población / MONOSTOTIC FIBROUS DYSPLASIA SIMULATING A NEOPROLIFERATIVE INTRAORAL NEOPLASM IN A FEMALE WITH AIDS. FIRST CASE REPORTED IN THIS POPULATION

Objetivo: Los pacientes con enfermedad por el virus de la inmunodeficiencia humana suelen presentar lesiones orales, hasta en un 50% de los casos con diagnóstico de sida. La displasia fibrosa es una lesión intra-ósea caracterizada por una alteración del crecimiento y diferenciación de los osteoblastos debida a una mutación genética. Clínicamente se caracteriza por presentar una tumoración de lento crecimiento con dolor, deformidad ósea y, en ocasiones, fracturas ante traumas mínimos. Caso clínico: Se presenta una paciente con sida y tuberculosis diseminada que desarrolló una lesión ósea tumoral , con compromiso de paladar y encía superior derecha, cuyo diagnóstico histopatológico fue de displasia fibrosa de paladar óseo y maxilar superior. Conclusión: La displasia fibrosa debe incluirse en el diagnóstico diferencial de las lesiones tumorales orales de los pacientes con enfermedad VIH/sida.

Aim: Patients with human immunodeficiency virus infection usually have oral lesions, including up to 50% of patients diagnosed with AIDS. Fibrous dysplasia is an intra-bone lesion, characterized by an alteration of the growth and differentiation of osteoblastes produced by a genetic mutation. Clinically it is characterized by presenting a tumor of slow growth with pain, bone deformity and sometimes fractures to minimal trauma. Clinical case: Here we describe a patient with AIDS and disseminated tuberculosis who developed a large tumor lesion that involve the hard palate and the maxilla. Final histopathological diagnosis was of fibrous dysplasia involving the hard palate and the upper maxilla. Conclusion: fibrous dysplasia should be included in the differential diagnosis of intraoral tumor lesions in HIV/AIDS patients.

Avaliação da fala pré-tratamento e pós-tratamento fonoaudiológico associado ao biofeedback ultrassonográfico de língua e de prótese bucomaxilofacial no câncer de cavidade oral / Evaluation of speech before and after speech therapy associated with ultrasound biofeedback of tongue and bucomaxillofacial prosthesis in oral cavity cancer

RESUMO As próteses bucomaxilofaciais (PBMF) têm como objetivo a reabilitação oral de pacientes com mutilações decorrentes de cirurgias de câncer de boca. Como parte dessa reabilitação oral, a terapia fonoaudiológica associada ao biofeedback ultrassonográfico da língua possibilita melhor precisão da produção de fala. O presente estudo teve por objetivo caracterizar a produção de fala de um indivíduo com histórico de múltiplas cirurgias oncológicas que levaram à glossectomia total, com auxílio de um dispositivo individualizado de acrílico, idealizado a partir da parceria Odonto-Fonoaudiologia da instituição e confeccionado por especialista em PBMF e terapia fonoaudiológica, utilizando o biofeedback visual com ultrassonografia. O indivíduo era homem, 45 anos, professor aposentado com histórico de carcinoma epidermóide de língua com episódios de recidiva. Como tratamento oncológico, foram realizadas diversas cirurgias associadas à radioterapia, ao longo de sete anos. O tratamento oncológico culminou com a glossectomia total e instalação de osteorradionecrose de mandíbula. O tratamento desta sequela da radioterapia também exigiu múltiplas abordagens cirúrgicas, com perda de grande parte da mandíbula, levando ao severo comprometimento das funções de deglutição e fala. Durante o atendimento multiprofissional da equipe Odonto-Fonoaudiologia de um hospital universitário, foi idealizada a confecção de um dispositivo individualizado de acrílico, objetivando melhorar a inteligibilidade da fala do paciente. Tal dispositivo foi confeccionado por dentista especialista em PBMF e ajustado em conjunto com a equipe de Fonoaudiologia. Com o dispositivo de acrílico adaptado, o indivíduo iniciou a terapia fonoaudiológica associada ao biofeedback, por meio da ultrassonografia de língua, com o objetivo de promover o refinamento da produção de fala dos fones fricativos [s] e [∫]. Ao comparar a avaliação pré-terapia e pós-terapia, foi possível identificar, após a análise das falas por juízes, melhora quanto à Porcentagem de Consoantes Corretas, de moderadamente severa para levemente moderada, bem como a inteligibilidade de fala, de insuficiente para regular. O dispositivo individualizado com a terapia fonoaudiológica associada ao biofeedback produziram resultados de fala satisfatórios, considerando-se a gravidade do caso e o elevado grau de mutilação do paciente.

ABSTRACT The oral maxillofacial prostheses (PBMF) aim the oral rehabilitation of patients with mutilations resulting from oral cancer surgery. The oral rehabilitation was composed of speech therapy associated with ultrasound biofeedback of the tongue, which allows better precision in speech production. The present study aims to characterize the speech production of an individual with a history of multiple oncological surgeries with total glossectomy with the aid of an individualized acrylic device, designed based on the partnership between Dentistry and Speech Therapy and made by a prosthetic dentist, undergoing therapy and speech therapy with visual biofeedback by ultrasound. The individual is a 45-year-old man, retired teacher with a history of tongue squamous cell carcinoma with episodes of recurrence. The cancer treatment was performed by several surgeries associated with radiotherapy over seven years. This treatment resulted in total glossectomy and the presence of osteoradionecrosis (ORN) of the mandible. The sequel to radiotherapy also required multiple surgical approaches with loss of a large part of the jaw, causing severe impairment of swallowing and speech functions. During the multidisciplinary care provided by the Dentistry and Speech Therapy team at a university hospital. The creation of an individualized acrylic device was conceived, aiming to improve the speech intelligibility of the patient. This device was made by a prosthetic dentist and adjusted together with the Speech Therapy team. With the adapted acrylic device, the individual started speech therapy associated with biofeedback by means of tongue ultrasound with the aim of promoting the refinement of the speech production of the fricative headphones [s] and [∫]. When comparing the pre-therapy and post-therapy assessment (after the analysis of the speeches by judges) it was possible to identify an improvement in the Percentage of Consonants Correct (PCC) from moderately-severe to slightly-moderate, as well as speech intelligibility from insufficient to regulate. The individualized device with speech therapy associated with biofeedback produced satisfactory speech results, considering the severity of the case and the high degree of mutilation of the patient.

Extensive malignant melanoma of the oral cavity: a rare occurrence

Primary malignant melanoma of the oral cavity is a rare tumor in clinical practice. Extensive malignant melanomas are still very rare in the literature. Patients with malignant melanoma of oral cavity are often diagnosed at the advanced stage of the disease due to their painless and nonspecific radiological findings. Histopathology is the gold standard for the final diagnosis and staging of the tumor. Surgery followed by radiotherapy is the standard treatment offered to patients with malignant melanoma. Here we present a rare case of extensive malignant melanoma of oral cavity which was successfully managed by surgical excision followed by adjuvant radiotherapy.

Progress in application of near-infrared fluorescence imaging in the diagnosis and treatment of oral cancer / 中南大学学报(医学版)

The preliminary screening of oral cancer mostly depends on the experience of clinicians, The surgical margin of tumor is mostly based on physical examination and preoperative imaging examination. It lacks real-time and objective intraoperative evaluation methods. Indocyanine green (ICG), as a safe and pollution-free organic fluorescent pigments, combined with near-infrared fluorescence imaging can be applied in the screening of early oral cancer, the determination of tumor resection margins, sentinel lymph node biopsy, cervical lymph node dissection, targeted chemotherapy, and other aspects. Near-infrared fluorescence imaging may become a key link in the early diagnosis and accurate treatment for oral cancer in the future.

Oral Squamous Cell Carcinoma Associated with Arsenic Exposure: A Case Series from Argentina / Carcinoma Oral de Células Escamosas Asociado con la Exposición al Arsénico: Una Serie de Casos de Argentina

ABSTRACT: Many areas of South America are directly affected by Arsenic (As) contaminated groundwater. A high percentage of the water samples taken in multiple areas of Argentina had As concentrations above the WHO level recommended guidelines. This condition was previously associated with an increased risk of chronic diseases, including different cancers. Long-term As exposure was proposed as a risk factor for Oral Squamous Cell Carcinoma (OSCC). The aim of this study is to present a series cases of Argentine patients diagnosed with OSCC who have consumed water contaminated with As for more than 10 years. Clinical data were obtained from the archive of Clinical Records Histories of the Oral Medicine Department of the Dentistry School, Universidad Nacional de Córdoba and Universidad Católica de Córdoba, Argentina. 15 cases of OSCC were included. The male: female sex ratio was 2:1. The average age was 66 years (31-89 years). Regarding location, the gum or edentulous alveolar ridge was the most prevalent site (6/15; 40 %), followed by the tongue margin. The average years of exposure to arsenical waters were 24 years (13 - 40 years of exposure). The majority of the presented cases were non drinkers non smokers. 60 % of the tumors were diagnosed at advanced stages. the epidemiological studies carried out in As-contaminated areas that address oral cancer should always incorporate the record of variables related to As exposure. Patients who live or lived at As-contaminated areas must be regularly followed up for early diagnosis of potentially malignant or malignant lesions. The high frequency of gum cancer among these cases, should raise awareness of periodontic specialists to perform a careful and thorough periodontal examination.

RESUMEN: Muchas regiones de América del Sur están directamente afectadas por aguas subterráneas contaminadas con arsénico (As). Un alto porcentaje de las muestras de agua tomadas en múltiples áreas de Argentina tenían concentraciones de As superiores al nivel aprobado por la OMS. Esta condición se asociaba previamente con un mayor riesgo de enfermedades crónicas, incluidos diferentes tipos de cáncer. La exposición a largo plazo se propuso como un factor de riesgo para el carcinoma oral de células escamosas (OSCC). El objetivo de este estudio es presentar una serie de casos de pacientes diagnosticados con OSCC que han consumido agua contaminada con As durante más de 10 años. Se obtuvieron datos clínicos del archivo de Historias de registros clínicos del Departamento de Medicina Oral de la Facultad de Odontología, Universidad Nacional de Córdoba y Universidad Católica de Córdoba, Argentina. Se incluyeron 15 casos de OSCC. La relación de género masculino: femenino fue de 2: 1. La edad promedio fue de 66 años (31-89 años). En cuanto a la ubicación, la encía o la cresta alveolar edéntula fue el sitio más frecuente (6/15; 40 %), seguido del borde de la lengua. El promedio de años de exposición a las aguas arsenicales fue de 24 años (13 - 40 años de exposición). La mayoría de los casos presentados fueron de pacientes no bebedores y no fumadores. El 60 % de los tumores fueron diagnosticados en etapas avanzadas. Los estudios epidemiológicos realizados en áreas contaminadas con As que abordan el cáncer oral siempre deben incorporar el registro de variables relacionadas con la exposición a As. Se debe hacer un seguimiento continuo de los pacientes que viven o que vivieron en áreas contaminadas con As para el diagnóstico temprano de lesiones potencialmente malignas. La alta frecuencia de cáncer de encías en estos casos, debe concienciar a los especialistas en periodoncia para que realicen un examen periodontal cuidadoso y completo.

Peripheral T-cell lymphoma not otherwise specified with oral manifestation: a case report / Linfoma periférico de células T no especificado con manifestación oral: reporte de caso

Peripheral T-Cell Lymphoma Not Otherwise Specified it is a rare type of Non-Hodgkin t-cells malignant tumor whose oral manifestations are difficult to diagnose. A case of a 48-year-old male with a hemi-maxillary lesion histological and immunohistochemically compatible with Peripheral T-Cell Lymphoma not otherwise specified is presented. A case of a 48-year-old male with a hemi-maxillary lesion histological and immunohistochemically compatible with Peripheral T-Cell Lymphoma not otherwise specified is presented. The patient treatment consisted of chemotherapy, but after the second cycle, died from immunosuppressive complications. Early stage diagnosis of oral lesions is imperative to avoid aggressive treatment and low overall survival rate of such pathologies.

Introducción: El linfoma periférico de células T no especificado es un tipo raro de tumor maligno no Hodgkin de células T cuyas manifestaciones orales son difíciles de diagnosticar. Se presenta el caso de un varón de 48 años con lesión hemimaxilar histológica e inmunohistoquímicamente compatible con linfoma periférico de células T no especificado. El tratamiento del paciente consistió en quimioterapia, pero después del segundo ciclo, falleció por complicaciones inmunosupresoras. El diagnóstico temprano de las lesiones orales es imperativo para evitar un tratamiento agresivo y la baja tasa de supervivencia.

Anti-micro rna-221 a promising genetic therapy of oral squamous cell carcinoma (scc-25)

Abstract Micro-RNA-221(miR-221) is one of oncogenic miRNAs that plays a vital role in the development and progression of oral cancers. The aim of this study is to introduce a new gene therapy for oral squamous cell carcinoma by blocking the expression of oncogenic miR-221 by its inhibitor. The present work was performed on squamous cell carcinoma cell line SCC-25 and anti-miR-221 was delivered to the cells using an ultrasound micro bubbles. Assessment of the effect of miR-221 inhibitor on SCC-25 cells was done using MTT assay, cell cycle analysis and apoptosis detection. In addition, reverse transcription-polymerase chain reaction was also used to detect the expression -miR-221 and its target genes. Using ANOVA, statistical analysis of the results showed significant inhibition of cell viability with and induction of cell apoptosis of SCC-25 cell line after transfection. Moreover, the expression of miR-221, Epidermal growth factor receptor (EGFR) and CDKNIB/p27 were downregulated without significant difference. Transfection of SCC-25 by inhibitor of miR-221 resulting in blockage of its expression leading to arresting of tumor growth. These results proved the effective role of micro-RNA inhibitors as novel therapeutic agent for oral cancers.

Resumo Micro-RNA-221 (miR-221) é um dos miRNAs oncogênicos que desempenham um papel vital no desenvolvimento e progressão de carcinomas orais. O objetivo deste estudo é apresentar uma nova terapia gênica para o carcinoma epidermóide oral por meio do bloqueio da expressão do miR-221 oncogênico por seu inibidor. O presente trabalho foi realizado na linhagem de células de carcinoma de células escamosas SCC-25 e o anti-miR-221 foi administrado às células usando micro-bolhas de ultrassom. A avaliação do efeito do inibidor miR-221 em células SCC-25 foi feita usando ensaio de MTT, análise do ciclo celular e detecção de apoptose. Além disso, a reação em cadeia da polimerase com transcrição reversa também foi usada para detectar a expressão -miR-221 e seus genes-alvo. Usando ANOVA, a análise estatística dos resultados mostrou inibição significativa da viabilidade celular e indução da apoptose celular da linhagem celular SCC-25 após a transfecção. Além disso, a expressão de miR-221, receptor do fator de crescimento epidérmico (EGFR) e CDKNIB/p27 foram regulados para baixo sem diferença significativa. A transfecção de SCC-25 por inibidor de miR-221 resultou no bloqueio de sua expressão, levando à interrupção do crescimento do tumor. Esses resultados comprovaram o papel eficaz dos inibidores de micro-RNA como novo agente terapêutico para carcinomas orais.

Abordagem dos cirurgiões-dentistas da Estratégia Saúde da Família sobre o câncer bucal / Analysis of the dental surgeon approach of the Familt Health Strategy on the oral cancer

Objetivo: este estudo busca analisar a atuação dos cirurgiões-dentistas da rede pública de saúde acerca do câncer bucal. Método: trata-se de um estudo transversal no qual foram entrevistados 217 dentistas. A coleta de dados foi realizada por meio de um questionário estruturado, enviado via e-mail, pelo Conselho Regional de Odontologia do Rio Grande do Norte. Resultados: um terço dos profissionais relatou ser capaz de realizar biópsias e citologia esfoliativa, mas apenas 15,2% das unidades de saúde possuíam condições materiais para fazê-las. Cerca de 85% dos cirurgiões-dentistas possuíam o conhecimento básico sobre o câncer bucal e 66,8% realizavam ações educativas-preventivas. Conclusão: embora a maioria dos cirurgiões-dentistas tivessem conhecimento adequado para realizar o diagnóstico bucal, a maioria não era capaz de realizar procedimentos cirúrgicos com finalidade diagnóstica. A realização desse exame durante a atenção primária é perfeitamente possível, por necessitar de baixa complexidade de equipamentos, e sua eficácia no diagnóstico permite a detecção precoce e o início do tratamento em estágios iniciais da doença, podendo reduzir as taxas de mortalidade por câncer bucal.(AU)

Objective: this study sought to analyze the performance of dental surgeons in the public health network regarding oral cancer. Method: this is a cross-sectional study in which 217 dentists were interviewed. Data collection was conducted through a structured questionnaire sent via e-mail, by the Regional Council of Dentistry of Rio Grande do Norte. Results: one third of the professionals reported being able to perform biopsies and exfoliative cytology, but only 15.2% of the Health Units had material conditions to carry them out. About 85% of dental surgeons had basic knowledge about oral cancer, and 66.8% performed educational- preventive actions. Conclusion: although most dental surgeons had adequate knowledge to perform the oral diagnosis, most of them were not able to perform surgical procedures for diagnostic purposes. The performance of this exam in primary care is perfectly possible because it requires low equipment complexity, and its effectiveness in diagnosis allows for early detection and initiation of treatment in the early stages of the disease, which can reduce oral cancer mortality rates.(AU)

Sclerotherapy of benign oral vascular lesions with non-diluted ethanolamine oleate / Escleroterapia de lesiones vasculares orales benignas con oleato de etanolamina no diluido

Benign oral vascular lesions are anomalies characterized by the blood vessels proliferation or malformation and the treatment with the sclerosing agent ethanolamine oleate acts irrigating the vessel producing a sterile inflammatory response. The objective of this study was to report and discuss the results from treatment of benign oral vascular lesions with non-diluted ethanolamine oleate through the analysis of clinical records. The sample was composed by the selection of twenty-six patients (12 male and 14 female), with oral vascular malformations. All lesions were treated with intralesional injections of undiluted ethanolamine oleate. These patients attended in Oral Medicine outpatient clinic of the Federal University of Paraná between the years of 2011 to 2015. The average age was 60.65 years, with a higher prevalence for women. The majority of the individuals had one lesion and its location was mostly in the lower lip. The main complaint was about a physical discomfort. The lesions had the average size of 6.52 mm and received a median number of 2.32 applications. Only one patient reported feeling pain in the postoperative week. In most cases the resolution of the lesion was considered partial. Follow-up was obtained up to one month after the end of treatment. The sclerotherapy with undiluted ethanolamine oleate shows acceptable results in the treatment of small benign oral vascular lesions with a few minor side effects.

Las lesiones vasculares orales benignas son anomalías caracterizadas por la proliferación o malformación de los vasos sanguíneos y el tratamiento con el agente esclerosante etanolamina oleato actúa irrigando el vaso produciendo una respuesta inflamatoria estéril. El objetivo de este estudio fue informar y discutir los resultados del tratamiento de lesiones vasculares orales benignas con oleato de etanolamina no diluido a través del análisis de historias clínicas. La muestra estuvo compuesta por la selección de veintiséis pacientes (12 hombres y 14 mujeres), con malformaciones vasculares orales. Todas las lesiones fueron tratadas con inyecciones intralesionales de oleato de etanolamina sin diluir. Estos pacientes acudieron a la clínica ambulatoria de Medicina Oral de la Universidad Federal de Paraná entre los años 2011 a 2015. La edad promedio fue de 60,65 años, con una mayor prevalencia para las mujeres. La mayoría de los individuos tenían una lesión y su ubicación era principalmente en el labio inferior. La queja principal era sobre una molestia física. Las lesiones tenían un tamaño promedio de 6,52 mm y recibieron una mediana de 2,32 aplicaciones. Solo un paciente informó haber sentido dolor en la semana postoperatoria. En la mayoría de los casos, la resolución de la lesión se consideró parcial. El seguimiento se obtuvo hasta un mes después del final del tratamiento. La escleroterapia con oleato de etanolamina sin diluir muestra resultados aceptables en el tratamiento de pequeñas lesiones vasculares orales benignas con algunos efectos secundarios menores.

Multidisciplinary team model for patients with oral cancer and systemic diseases: an expert consensus / 华西口腔医学杂志

Large general hospitals currently play an increasingly important role in the diagnosis and treatment for acute critical patients and difficult diseases because of the development of dual referral system and hierarchical diagnosis, as well as the formation of medical treatment alliance. Patients with oral cancers are often associated with systemic diseases, which increases the complexity of the condition. Thus, meeting the demand through the traditional single medical model is difficult. As such, a multidisciplinary team (MDT) model has been proposed and has achieved a good clinical effect. To standardize the application of this model, we organized an event in which relevant experts discussed and formulated a consensus to provide standardized suggestions on the MDT process and the diagnosis and treatment of common systemic diseases as reference for clinical practice.

Necessidades humanas de cuidado no homem em tratamento cirúrgico oncológico: implicações para a enfermagem / Necesidades humanas de cuidado en el hombre en tratamiento cirúrgico oncológico: implicaciones para la enfermería / The human care needs for men undergoing oncological surgical treatment: implications towards the nursing profession

Objective: The study's goal has been to identify the basic human needs of men undergoing oncologic surgical treatment and its implications for nursing care. Methods: It is a descriptive study with a qualitative approach. The scenario is the Nursing Consultation Ambulatory, INCA-RJ. The participants were 25 men bearing mouth neoplasm under exclusively surgical treatment. Study approved by the Research Ethics Committee under the CAAE No. 52647116430015274. Data collection was carried out through a semi-structured interview. The Bardin's thematic content analysis was used. Results: Three thematic categories emerged, as follows: the human needs for health care of the physical body; the human needs for social health care and the human needs for spiritual health care. Conclusion: The human needs affected by organic imbalances point to the importance of planning a care service that provides an effective result to human health necessities

Objetivo: Identificar as necessidades humanas básicos da saúde do homem em tratamento cirúrgico oncológico e suas implicações para o cuidado de enfermagem. Método: Estudo descritivo, qualitativo. Cenário ambulatório de Consulta de Enfermagem, INCA-RJ. Participantes foram 25 homens com neoplasia de boca em tratamento exclusivamente cirúrgico. Após aprovação do CEP n°52647116430015274. A coleta de dados foi à entrevista semiestruturada. Utilizou-se a análise temática de conteúdo de Bardin. Resultados: Emergiram três categorias temáticas: as necessidades humanas de cuidado à saúde do corpo físico; as necessidades humanas de cuidado a saúde social e as necessidades humanas de cuidado a saúde espiritual. Conclusão: Deste modo, as necessidades humanas afetadas com desequilíbrios orgânicos, aponta a importância de planejar um cuidado que proporcione resultado efetivo às necessidades à saúde do homem

Objetivo: Identificar las necesidades humanas básicas de la salud del hombre en tratamiento quirúrgico oncológico y sus implicaciones para el cuidado de enfermería. Método: Estudio descriptivo, cualitativo. Escenario ambulatorio de Consulta de Enfermería, INCA-RJ. Los participantes fueron 25 hombres con neoplasia de boca en tratamiento exclusivamente quirúrgico. Tras la aprobación del CEP n ° 52647116430015274. La recolección de datos fue a la entrevista semiestructurada. Se utilizó el análisis temático de contenido de Bardin. Resultados: emergieron tres categorías temáticas: las necesidades humanas de cuidado de la salud del cuerpo físico; Las necesidades humanas de cuidado de la salud social y las necesidades humanas de cuidado de la salud espiritual. Conclusión: De este modo, las necesidades humanas afectadas con desequilibrios orgánicos, apunta la importancia de planificar un cuidado que proporcione resultado efectivo a las necesidades de la salud del hombre

Determination of Factors Associated with Critical Weight Loss in Oral Cavity Carcinoma Patients: A Retrospective Cohort Study

Abstract Introduction Critical weight loss is defined as an unintentional weight loss of ≥ 5% at 1 month or ≥ 10% at 6 months from the start of treatment. Critical weight loss leads to deterioration of the immune function and reduced tolerance to treatment (surgery ± radiochemotherapy) as well as increased complication rates. Objective Critical weight loss, defined as a weight loss of ≥ 5% after 1 month or ≥ 10% after 6 months from the start of treatment, is not uncommon in head and neck cancer patients. We aimed to assess the factors associated with critical weight loss during the treatment of oral cavity squamous cell carcinoma patients. Methods A retrospective cohort study was performed at the Aga Khan University Hospital, in Karachi, Pakistan, on 125 patients. Patients receiving adjuvant therapy were considered exposed, and the outcome was critical weight loss. Results The mean age of presentation was 46.9 ± 12.8 years in patients undergoing surgery and adjuvant therapy, with 119 (79.3%) of them being male and 31 (20.7%) female. One hundred and twelve patients (81.3%) developed critical weight loss at 6 months from the start of treatment, and the only significant variable associated with critical weight loss was the stage of the disease (p= 0.03). Conclusion A large proportion of patients with oral cancer developed critical weight loss requiring a need for intervention. The overall stage of the disease is a significant predictor of critical weight loss in patients undergoing treatment.

Frecuencia de Lesiones y Condiciones Orales en Pacientes Mayores de 18 Años en una Clínica de Atención Primaria en México / Frequency of Lesions and Oral Conditions in Patients Older than 18 Years in a Primary Care Clinic in Mexico

RESUMEN: La patología oral es el área de la odontología que se especializa en el diagnóstico y tratamiento de enfermedades orales. Se realizó un estudio transversal, en el cual fueron incluidos pacientes mayores de 18 años que acudieron a una clínica de atención primaria del departamento de estomatología de la universidad Autónoma de Ciudad Juárez, en México y a los cuales independientemente del motivo de consulta se les realizo historia clínica y exploración intraoral detallada. Fueron examinados 650 pacientes (424 mujeres y 226 hombres) con un rango de edad de 18 a 89 años (media=42.27). Las lesiones más frecuentes fueron la queratosis friccional (30,46 %) e hiperplasia fibrosa (6,92 %), la melanosis fisiológica (42,92 %) y los gránulos de Fordyce (36,46 %) fueron las condiciones más identificadas. En las lesiones de la mucosa oral que identificamos estuvo presente el factor traumático de manera crónica, es importante que el odontólogo este familiarizado con las lesiones más frecuentes, con su etiología, características clínicas y tratamiento de cada una de ellas.

ABSTRACT: Oral pathology it's the branch of medicine that focuses on the diagnosis and treatment of oral diseases. A cross-sectional study was carried out in which patients older than 18 years was included, that were attended in the primary care clinic at the stomatology department of the Autonomous University of Ciudad Juárez, in Mexico, and regardless of the reason for consultation the clinical history and intraoral examination was done We examined 650 patients (424 women and 226 men) with an age range of 18 to 89 years (mean=42.27). The most frequent oral lesion was the frictional keratosis (30.46 %), fibrous hyperplasia (6.92 %), physiological melanosis (42.92 %), and fordyce granules (36.46 %). In the oral mucosal lesions identified was present a chronic traumatic factor, it is important that the dental staff knows about the most frequent injuries, their etiology, clinical characteristics and treatment of each one.

Carcinoma escamoso de cavidad oral en paciente menor de edad / Oral squamous cell carcinoma in an underage patient

El objetivo de este caso es profundizar en el conocimiento del cáncer de lengua en pacientes jóvenes. Se trata de un caso clínico: Mujer de 17 años sin antecedentes ni hábitos tóxicos, que acude por presentar tumoración en hemilengua izquierda con biopsia de carcinoma escamoso. En TAC: Lesión en hemilengua izquierda que afecta al suelo de la boca. Adenopatías bilaterales. Estadío IVA. Se decide quimioterapia de inducción seguido de quimioradioterapia. Presentó recidiva tras 5 meses de seguimiento, y se realizó glosectomía parcial. Tras 12 meses libre de enfermedad presentó nueva recidiva local que se intervino quirúrgicamente. Actualmente en seguimiento y sin signos de enfermedad. Existen estudios que indican que la prevalencia del cáncer de cabeza y cuello está aumentando en pacientes jóvenes; comportándose de forma diferente entre unos grupos de edad y otros. Concluimos que los factores epidemiológicos, genéticos, etiológicos y clinicopatológicos de los pacientes jóvenes con cáncer de cabeza y cuello sugieren una divergencia biológica frente a lo que ocurre con dichos cánceres en pacientes añosos. La mejora del conocimiento de la biología molecular es necesaria para establecer el éxito en la prevención y el tratamiento de dichos pacientes.

To delve into the knowledge of tongue cancer in young patients. Case We presented a 17 years-old female, without tobacco and alcohol exposure, referred to Oral and Maxillofacial department with a squamous cell carcinoma in the tongue with bilateral cervical metastasis. We decided, in a multidisciplinary team, to treat her with chemotherapy followed by chemoradiotherapy. She had two local recurrences 5 and 12 months after the treatment which we treated with surgery both. Afher that, we follow her every month and she is without recurrences. Several reports suggest increasing incidence trends of head and neck cancer in young patients, disproportional to the patients above 45 years old. Moreover, the majority of young non-smoking non-drinking head and neck cancer patients is female. This disparity suggests that the pathogenesis of head and neck cancer in young patients differs from head and neck cancer development in old patients. Conclusion: The unique epidemiologic, genetic, etiologic, and clinicopatho- logic characteristics of young-onset HNSCC suggests a divergent biology from HNSCC occurring in older patients. Improved definition of this biology is needed to establish successful preventive and treatment de intensification efforts.

Oral plasmablastic lymphoma as the first manifestation of AIDS

Abstract Plasmablastic lymphoma is a non-Hodgkin lymphoma characterized by its plasmacytic differentiation and predilection for the oral cavity. It is among the lymphomas most commonly associated with AIDS. This report details a case of a HIV-positive patient with a 1-month history of an exophytic mass in the gingival area of the upper left quadrant. The diagnosis of plasmablastic lymphoma was made based on its histopathological and immunophenotypical features. She was treated with chemotherapy followed by autologous hematopoietic stem cell transplantation. Despite complete resolution of the lesion, the patient died of cardiorespiratory arrest. This case illustrates plasmablastic lymphoma as the first clinical manifestation of AIDS, highlighting the importance of differentiating between a potentially malignant lesion and other pathologic processes.

Queilitis actínica: aspectos histológicos, clínicos y epidemiológicos / Actinic cheilitis: histological, clinical and epidemiological characteristics

Introducción: la destrucción de la capa de ozono ha provocado un aumento en la incidencia de lesiones de la piel, a la que se suma la queilitis actínica. Objetivo: describir los aspectos histológicos, clínicos y epidemiológicos de la queilitis actínica a partir de la literatura reciente. Métodos: se revisaron las bases electrónicas PubMed, SciELO y Google Scholar con los términos claves en inglés y español: queilitis, queratosis, actínica, solar. Se incluyeron artículos originales, de revisión, reportes de casos, tesis y libros de la especialidad publicados preferentemente en el período 2005-2014. Resultados: La queilitis actínica es un trastorno potencialmente maligno inducido por la exposición solar y caracterizado por alteraciones micro y macroestructurales del labio. Factores de riesgo que interaccionan con la exposición solar son el fototipo (piel clara), hábito tabáquico, sexo (hombres), edad y ocupación (aire libre). Entre las alteraciones histológicas se encuentran la displasia epitelial y la elastosis solar; sin embargo, la severidad de estas no correlacionan con la gravedad clínica. Los pacientes con queilitis actínica presentan alteraciones de color, descamación, ulceraciones, difuminación del bermellón, entre otras. En muchas ocasiones la consulta y el diagnóstico son tardíos; se realizan cuando el cuadro ha evolucionado a cáncer. El diagnóstico es principalmente clínico, sumado a la biopsia de las lesiones con presentaciones moderadas y severas. Actualmente la terapia incluye métodos quirúrgicos y farmacológicos, y métodos innovadores como la fototerapia. Sin duda, la estrategia de prevención más importante es aumentar el uso de protectores solares, especialmente en la población de alto riesgo ocupacional. Conclusiones: la queilitis actínica es una patología relevante para los países sudamericanos, debido a que los factores de riesgo están presentes diariamente en las actividades de millones de trabajadores de nuestra región, por eso es necesario potenciar la investigación que permita mejorar la prevención, tratamiento y rehabilitación de esta patología(AU)

Introduction: depletion of the ozone layer has brought about an increase in the incidence of skin lesions, including actinic cheilitis. Objective: describe the histological, clinical and epidemiological characteristics of actinic cheilitis based on a review of recent literature. Methods: a search was conducted in the databases PubMed, SciELO and Google Scholar using the descriptors cheilitis, keratosis, actinic, solar, and their counterparts in Spanish. The search included original papers, review papers, case reports, theses and books about the specialty preferably published from 2005 to 2014. Results: actinic cheilitis is a potentially malignant condition induced by sun exposure and characterized by micro- and macrostructural alterations of the lip. The risk factors interacting with sun exposure are the skin phototype (light skin), smoking, gender (male), age and occupation (outdoor jobs). Histological alterations include epithelial dysplasia and solar elastosis, though their severity does not correlate with the degree of clinical seriousness. Patients with actinic cheilitis present color alterations, desquamation, ulceration and blurring of the vermillion border, among other signs and symptoms. On many occasions patients do not seek care during the early stages of the disease. As a result, diagnosis is made when the condition has already evolved into cancer. The diagnosis is basically clinic, with the support of the biopsy of lesions with moderate to severe characteristics. Current therapy includes surgery and medication, as well as innovative techniques like phototherapy. The most important strategy is no doubt the use of sunscreens, especially by the population at high occupational risk. Conclusions: actinic cheilitis is a condition relevant to South American countries, since its risk factors are present in the daily activities of millions of workers from our region. It is therefore necessary to foster research aimed at improving its prevention, treatment and rehabilitation(AU)

Correlation between C-Reactive Protein in Peripheral Vein and Coronary Sinus in Stable and Unstable Angina / Correlação entre Proteína C-Reativa em Veia Periférica e Seio Coronário na Angina Estável e Instável

Background: High sensitivity C-reactive protein (hs-CRP) is commonly used in clinical practice to assess cardiovascular risk. However, a correlation has not yet been established between the absolute levels of peripheral and central hs-CRP. Objective: To assess the correlation between serum hs-CRP levels (mg/L) in a peripheral vein in the left forearm (LFPV) with those in the coronary sinus (CS) of patients with coronary artery disease (CAD) and a diagnosis of stable angina (SA) or unstable angina (UA). Methods: This observational, descriptive, and cross-sectional study was conducted at the Instituto do Coração, Hospital das Clinicas, Faculdade de Medicina, Universidade de São Paulo, and at the Hospital Beneficência Portuguesa de Sao Paulo, where CAD patients referred to the hospital for coronary angiography were evaluated. Results: Forty patients with CAD (20 with SA and 20 with UA) were included in the study. Blood samples from LFPV and CS were collected before coronary angiography. Furthermore, analysis of the correlation between serum levels of hs-CRP in LFPV versus CS showed a strong linear correlation for both SA (r = 0.993, p < 0.001) and UA (r = 0.976, p < 0.001) and for the entire sample (r = 0.985, p < 0.001). Conclusion: Our data suggest a strong linear correlation between hs-CRP levels in LFPV versus CS in patients with SA and UA. .

Fundamento: A proteína C-reativa de alta sensibilidade (PCR-as) é comumente utilizada na prática clínica para avaliar o risco cardiovascular. Entretanto, a correlação entre os níveis séricos de PCR-as (valores absolutos) periférico versus central ainda não foi feita. Objetivo: Avaliar a correlação entre os níveis séricos de PCR-as (mg/L) em veia periférica do antebraço esquerdo (VPAE) versus seio coronário (SC), em pacientes portadores de doença arterial coronária (DAC) com diagnóstico de angina estável (AE) ou angina instável (AI). Métodos: Estudo observacional, descritivo, transversal, realizado no Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo e no Hospital Beneficência Portuguesa de São Paulo, onde foram avaliados os pacientes encaminhados ao hospital com DAC para angiografia coronária. Resultados: Quarenta pacientes com DAC (20 AE e 20 AI) foram incluídos no estudo. Amostras de sangue na VPAE e SC foram coletadas simultaneamente antes da angiografia coronária. A análise de correlação entre os níveis séricos de PCR-as em VPAE versus SC mostrou forte correlação linear tanto para AE (r = 0,993, p < 0,001) como para AI (r = 0,976, p < 0,001) e em toda a amostra (r = 0,985, p < 0,001). Conclusão: Nossos dados sugeriram forte correlação linear entre os níveis de PCR-as em VPAE versus SC na AE e AI. .

A 10-year analysis of the oral squamous cell carcinoma profile in patients from public health centers in Uruguay

The aim of this study was to evaluate the demographic, clinical, and therapeutic characteristics and predictive factors of poor prognosis in patients with primary oral squamous cell carcinoma (OSCC) in Uruguay. Medical records of patients with the diagnosis of primary OSCC treated between 2000 and 2010 in Uruguayan public hospitals were selected. Data on demographic characteristics, risk factors, clinical features, treatment, and outcome were collected. Associations of independent variables with outcomes were assessed using Pearson chi-squared and Fisher's tests. Of 200 patients with OSCC, 79.4% were men (3.8:1 male:female ratio), with a mean age of 60.75 ± 11.26 years. Tobacco and alcohol consumption were reported by 85.3% and 63.5% of patients, respectively. The most commonly affected location was the tongue (42.5%), with lesions exhibiting ulcerous aspects in 87.9% of cases and pain at the time of diagnosis in 70.4% of cases. One hundred sixty-one (82.1%) patients had advanced-stage (III/IV) OSCC. Surgery was the most common treatment option, and the overall 5-year survival rate was 58.5%. Univariate analysis showed that the predictors of poor prognosis were clinical aspect, size, regional metastasis, clinical stage, and treatment. In Uruguay, OSCC is diagnosed late, which is associated with a low survival rate. Educational and preventive measures and investment to improve early diagnosis should be undertaken.

Sobrevida en carcinoma espinocelular de mucosa oral: análisis de 161 pacientes / Survival in oral mucosa squamous cell carcinoma: analysis of 161 patients

Introduction: Oral Cancer accounts 3 percent of all human cancers. Squamous Cell Carcinoma is the most common. nowadays, in Chile and the world, oral cancer is reaching relevance because of its high incidence and low survival rates; most often is squamous cell carcinoma (SCC). Aim: We analyzed the five-year survival of 161 patients diagnosed with SCC. Also was studied relationships between survival and gender, age, location, tobacco, alcohol and treatment. Methods: Retrospective study among 1989 and 2010. The study population was mainly men gender (59 percent), average age 64 years and location of the CEC preferably in tongue (37.6 percent). 54 percent were well differentiated carcinomas and TOM, the majority corresponding to T2N0M0. Kaplan-Meier curve and Log Rank test were used for survival analysis and to compare them. We determined significant difference when p value < 0.05. Results: The overall survival at five years was 46 percent, the lowest rates were in the male gender, age group 60, floor of mouth, smokers and alcohol consumers. Conclusions: Although tobacco and alcohol are factors highly related to the presence of CEC, there was no significant difference between survival and these habits. There were differences between the survival curves for patients treated with surgery associated with radiotherapy in comparison to other treatments.

Introducción: Hoy en día, en Chile y el mundo, el cáncer oral ha tomado mayor importancia por su incidencia y bajos porcentajes de sobrevida, el más frecuente corresponde al Carcinoma Espinocelular (CEC). Objetivo: Analizar la sobrevida a cinco años de 161 pacientes de la Facultad de Odontología de la Universidad Mayor y Fundación Arturo López Pérez (FALP), diagnosticados con CEC de mucosa oral mediante biopsia. Se analizó cómo afecta a la sobrevida, el género, edad, localización, consumo de tabaco y/o alcohol y tratamiento. Material y método: Estudio retrospectivo entre los años 1989 y 2010. La población estudiada correspondía principalmente a hombres (59 por ciento), edad promedio de 64 años y ubicación del CEC preferentemente en lengua (37,6 por ciento). El 54 por ciento eran carcinomas bien diferenciados y, según TNM, la mayor parte correspondía a T2N0M0. Se utilizó para los análisis de sobrevida la curva de Kaplan-Meier y Log Rank Test para compararlas. Se determinó si existían diferencias significativas cuando el valor de p < 0,05. Resultados: La sobrevida general a los cinco años fue de 46 por ciento, las tasas más bajas fueron en el género masculino, el grupo mayores de 60 años, en piso de boca, fumadores y bebedores de alcohol. Conclusiones: A pesar que el tabaco y el alcohol son factores altamente relacionados a la presencia de CEC, no se observó diferencia significativa entre la sobrevida y estos hábitos. Hubo diferencia entre las curvas de sobrevida de pacientes tratados con cirugía asociada a radioterapia en relación a otros tratamientos.